


Brain Matter

by orphan_account



Category: The Resident (TV 2018)
Genre: F/M, Hurt/Comfort, Medical, Trauma, concussion
Language: English
Status: Completed
Published: 2019-10-14
Updated: 2019-10-22
Packaged: 2020-12-14 23:30:52
Rating: General Audiences
Warnings: No Archive Warnings Apply
Chapters: 3
Words: 6,556
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/21024032
Author URL: https://archiveofourown.org/users/orphan_account/pseuds/orphan_account
Summary: Nic hits her head but she thinks everything is fine. Conrad is suspicious. Nic whump, I'm a ho for hurt/comfort





	1. Chapter 1

**Author's Note:**

> A/N: This is my first fic for The Resident! I'm a whore for whump, especially between a pairing. I'm an EMT so I thought it would be cool to break down all the medical stuff at the end of each chapter. I'm not a doctor, but the info I provide is based on my knowledge as an EMT in the field for a little over 3 years. Hope you enjoy :) What will happen nexr? Please leave a review!

“I need restraints over here!” Pravesh called out as he and Nic attempted to hold the patient down. Several nurses rushed over to assist as the patient kicked and swung at them wildly, even ripping Nic’s ID badge from her coat and flinging it across the room. 

“Nic, get five of Haldol,” Pravesh added. 

Nic went to the med supply and grabbed the vial and a syringe, quickly returning to administer the dose into the patient’s arm. “There we go,” She soothed as he started to slow down, coming to a stop. They finished applying the restraints and Pravesh talked to a nurse, ordering more tests and medication.

“Thanks Nic,” Pravesh nodded.

“Yeah, of course,” She smiled and finally exhaled. She went off in search of her ID badge, crouching to get a better view of the floor. She spotted it underneath a vacant bed. She went over and had to crawl half under to grab it. As she was withdrawing, the loud clatter of a lac tray being dropped sounded nearby, causing her to jump. She smacked the back of her head hard on a metal bar underneath the bed. She gasped and groaned, seeing stars for a moment as she carefully backed out. Standing up slowly, she supported herself with a hand on the bed and the other holding the new bruise now forming.

“Jesus,” She sighed, blinking as the stars and pain dissipated. She waited for a moment but then felt fine. She breathed a sigh of relief.

She continued on, treating patients in the ER. A scalp lac in 4, strep in 8, and a wrist sprain in 14. She paused at the nurse’s station, writing up discharge instructions for her strep patient. Conrad saw her and joined her.

“Hey Nic,” He said with a soft smile.

“Hey,” She smirked, not looking up from the tablet. Suddenly her expression dropped, blinking hard.

“You okay?” Conrad curiously tilted his head.

“Yeah, I just have a killer headache,” She said simply.

“I’m telling you, you work too many hours,” He said, “Between the clinic and this hell hole…”

“You realize you are the biggest hypocrite I’ve ever met, right?” She chuckled.

“Alright, I’m just sayin!” he puts his hands up with a smile. Nic flinched again, reaching to touch her forehead. Conrad became serious. “Nic, are you sure you’re okay?” He said quietly, inching closer.

“Conrad, can you cover the ankle fracture in 7?” Nurse Hundley asked, holding a tablet out to him. Conrad glanced at her and then looked back to Nic.

“Go, I’m fine, I just need some Tylenol,” Nic reassured him, “Go.” 

“Yeah, I got it,” He replied to nurse Hundley and turning back to Nic added, “Take a break, okay?”

Nic only rolled her eyes in response and began making her way to the next patient. The pain had already subsided and she knew that she was fine.

After treating an asthma attack in room 12, she noticed her neck starting to feel stiff. Did she pull a muscle too? She tried to stretch a little but was interrupted by another sudden headache. She ran her fingers over the back of her head and found a large, painful bump. Seriously? She was annoyed by how much she had managed to injure herself crawling under a bed.

An unwelcome wave of nausea poured through her. Shit, do I have a concussion? She thought to herself. Maybe taking a break wasn’t such a bad idea. She stopped by the nurse’s station and told nurse Hundley that she would be right back.

When Nic finally made it to the empty lounge, she only felt worse. She grabbed the trashcan just in case and sat on the couch, trying to take deep breaths. She had never felt this way before. She ran through all the possible diagnoses and anxiety consumed her entirely. The pain in her head got stronger. She desperately wanted Conrad. She fumbled with the pager on her hip and managed to type in his number. 

Her anxiety lessened for a moment. At the very least, she knew Conrad would be at her side soon.

\-----

Pravesh was presenting a case to Conrad when his pager went off. Conrad was immediately concerned when he saw it was Nic, paging him to the lounge.

“Something serious?” Pravesh inquired as he noted the change in Conrad’s demeanor.

“Uh, it’s Nic,” he replied hesitantly, “She wasn’t feeling too great earlier. I need to go check on her.”

Pravesh sensed Conrad’s worry.

“Do you want me to come?” He offered.

“Yeah,” Conrad replied gratefully. Something was wrong. He just knew it. Both of them took off to the doctor’s lounge at a quick pace.

\-----

Nic tried to rest her head back against the couch, but the overhead lights seemed so blinding. Pain cracked in her head like thunder and she couldn’t suppress the small cry that escaped her. She couldn’t think of anything besides the deafening pain and the acute awareness that she was about to vomit. Her vision blurred as she gripped onto the trashcan and threw up.

Conrad and Pravesh were almost to the door when they heard Nic getting sick. They exchanged alarmed looks and quickly burst through the door.

“Nic?!” Conrad called. He saw her sitting on the couch, pale, crying, and confused. He darted over, Pravesh on his heels. Nic reached out towards Conrad, holding onto his arms desperately. “Nic?” He repeated.

“Conrad,” she looked at him helplessly before trailing off, “M-my head, I…”

He caught the slight slurring of her words and disoriented eyes. This was not the Nic they knew.

“We need to get her to the ER now,” Conrad said to Pravesh who nodded in agreement, “Can you grab a wheelchair?” Pravesh started towards the hallway in search of one.

“Nic, we’re gonna get you to the ER, okay?” Conrad explained, shifting to help her up. She nods and weakly makes it onto her feet. Conrad feels how unsteady she is as they take a couple steps forward. She came to a stop.

“Con-“ she rasped in a low voice, finding it hard to form the words, “Some-something’s wrong.” Her gaze looked distant and panicked. 

“Nic, talk to me,” Conrad said, intensely searching her face for clues and trying not to panic himself. 

She wanted to tell him that she had hit her head, that she was in pain and dizzy and scared, but she just couldn’t get it out. 

“I h-“ She started but suddenly stopped, her eyes wandering away from Conrad’s.

“Nic?” Conrad tried to get her attention. 

Her muscles tensed and she started to fall. 

“Whoa!” Conrad grabbed ahold of her before shouting over his shoulder, “Devon?!” Conrad saw she was conscious but nowhere near reality. “I got you, I got you,” he said quietly. 

Pravesh had sprinted over, taking on some of Nic’s weight. “Let’s get her on the floor,” Conrad directed him before adding, “Watch her head.” As they laid her down, she started to shake.

“God, she’s seizing,” Conrad said in shock, pulling her onto her side, “Pravesh Go!” 

Pravesh tore his eyes away as he ran out to get help.

“I’m right here Nic, it’s okay,” he soothed quietly as he held her on her side. He took out his penlight and checked each eye. Both were sluggish but reactive. “You’re gonna be okay,” he said softly.

He wracked his brain. What the hell was happening--headache, vomiting, confusion, seizures, and an otherwise healthy young woman? Who had been fine just hours before when he woke up beside her? Maybe meningitis? He watched her struggle helplessly. Pravesh returned with a syringe, leading a small army of nurses and a gurney. He ran over and knelt down with Conrad.

“Hold her arm,” Pravesh requested and Conrad held her arm as still as possible without hurting her. “Five of diazepam going in,” Pravesh announced as he quickly administered the injection. Within seconds, Nic’s body began to still and relax. It was a small relief for Conrad to see the seizure end. 

Now surrounded by the nurses, Conrad directed them: “Lift on three—one, two, three.” They quickly started rolling her to the elevator.

“Nic?” Conrad tried to wake her, “Nic, can you hear me?” He gave her a sternal rub and her eyes fluttered to life. She began to resist weakly, too confused and scared to understand what was happening. 

“Oh-” Pravesh and the others go to gently still her, “She’s definitely post ictal.”

She cried out and Conrad felt his heart breaking in two. “Nic, it’s okay,” Conrad comforted her quickly and placed a hand on her cheek, “It’s Conrad, it’s me.” 

She looked at him with drowsy eyes and calmed down.

“You’re okay,” Conrad reassured her with a small smile as he brushed a stray hair from her face, “You had a seizure, but we’ve got you, okay?” He very quietly whispered, “I love you.” 

She nodded in response, wishing she could say it back, wishing he could hold her, wishing that this would all stop. It was too overwhelming. She closed her eyes and drifted off again.

**Here's a breakdown of all the medical info in this chapter, in case you're curious:  
"Nic, get five of Haldol": Haldol is an antipsychotic drug, which can essentially function as a tranquilizer at this dose.**

**"She ran her fingers over the back of her head and found a large, painful bump": this is a hematoma, aka a bruise. Usually when someone says “hematoma” rather than just “bruise” it’s because hematomas are associated with being super 3-D and have that “goose egg” kind of shape. Hematomas happen on the head pretty frequently because the head has a lot of blood vessels (got to supply that brain with blood!).**

**"The overhead lights seemed so blinding": Sensitivity to light, called photophobia, is common after head injuries.**

**"Her muscles tensed and she started to fall/Conrad saw she was conscious but nowhere near reality": So typically when someone faints (aka has a syncopal episode), their body goes limp and their eyes shut, but Nic’s body tensed up with her eyes open. Why? Because Nic was not having a syncopal episode, she was in the first stage of a tonic-clonic seizure. The “tonic” phase is characterized by stiffening and the “clonic” phase is characterized by shaking/jerking movements. It’s actually kind of uncommon to have this type of seizure with your eyes shut. They usually remain open, though the patient is completely unaware and basically unconscious.**

**"Five of diazepam going in": Diazepam, also called Valium, can be used to stop seizures at this large of a dose. It belongs to a class of drugs known as benzodiazepines, which are often prescribed in smaller doses for anxiety.**

**"Maybe meningitis?": Let’s look at the symptoms Conrad knows about when he thinks that Nic might have meningitis.  
-headache  
-vomiting  
-confusion  
-weakness  
-seizure**

**When I look at that list and consider that my patient is an otherwise healthy woman, mid 30’s, works in a hospital, and had a fast onset of symptoms, I immediately consider meningitis. However, if I found out that she had hit her head, I would consider that the symptoms were due to the trauma, not a sickness. As the reader, we know that Nic has hit her head and isn’t ill, but Conrad and the team don’t know that until they can discover it themselves. **

**"He gave her a sternal rub and her eyes fluttered to life": When a patient is unconscious, sometimes they can be woken up with a little painful stimulation. Rubbing a knuckle on someone’s sternum (aka breastbone) hurts and can help bring them back around. **

**"She’s definitely post ictal": After a seizure, the brain has to recover. This period is known as the “post ictal” state (post meaning after, ictal meaning seizure). When patients are post ictal, they can be confused, drowsy, combative, disoriented, etc, hence why Nic tries to fight them when she wakes up. ******


	2. Chapter 2

**Summary for the Chapter:**

> A/N: Chapter 2 is here! Let me know if you like how I do medical breakdowns at the end of each chapter. I’ve never seen anyone else do them, but I feel like if you’re watching a medical show, you’re probably interested in medical topics? Idk please tell me lol. Leave a comment if you have a second, it’s much appreciated :)

They rushed in through the ER doors and Irving looked up, catching the distraught look on both Pravesh and Conrad’s face.

“Conrad?” Irving probed as they rushed by.

“It’s Nic,” He quickly replied.

This caught Dr. Nolan’s attention as well and both doctors dropped what they were doing, following after them.

“What happened?” Irving asked in confusion. She was fine 20 minutes ago. 

“New onset seizure, complained of a headache earlier, vomited,” Conrad summarized, “We’ve got five of diazepam on board, someone get me IV access and page neuro.”

There was a flurry of activity and tests being ordered. Conrad focused back down on Nic.

“Nic? Can you hear me?” He tried, rubbing her sternum again. This time she opened her eyes only for a moment and whimpered as she made a subtle attempt to push Conrad’s hand away. Conrad noted her irregular breathing. “She’s not moving enough air,” Conrad said aloud somberly, “Pravesh, bag her. 

Pravesh went to put the mask over her face when suddenly Nic began to gag. “She’s vomiting,” He alerted.

“Roll her,” Irving demanded. Pravesh supported her head as the rest of the team placed her on her side.

“I need suction,” Conrad added as the team put Nic on her side. Pravesh took the opportunity to inspect her head.

“No fever, and her pressure is way too high,” Irving pondered as Conrad cleared her airway, “A stroke?”

“No,” Pravesh said confidently as he looked up from palpating her scalp, “There’s a hematoma on the back of her head. This was trauma.”

“What?” Conrad said quietly. When did she hit her head? What happened?

There was a brief pause as everyone adjusted to this new information.

“Roll her back down, _carefully_,” Nolan stressed, “Get her in a collar and get her to CT now. 

Pravesh returned to ventilating her with the mask, struggling to position her jaw. “She’s not protecting her airway,” He shook his head.

“We need to intubate-” Dr. Nolan started.

“No!” Conrad interjected.

“Conrad, she’s not protecting her airway,” Nolan repeated for him as he asked for the intubation meds and kit. Conrad was at a loss for words. This was all too much. He just stood silently, shaking his head. When had he started crying?

“Conrad, if she needs surgery, she’ll be intubated either way,” Irving tried to reason with him, “Nic needs this.” Conrad nodded. He knew they were right, he just wished that they weren’t. He watched as Nolan placed the tube and checked his work with a stethoscope.

“Okay, I’ve got bilateral breath sounds,” Nolan said, “Tell CT we’re coming.”

\----

Doctor Voss joined them in the CT room, along with the neurosurgeon on call, Doctor Jacobs. Dr. Voss scrolled through the image as it appeared.

“C-spine is clear,” She nodded, “There’s no spinal injury.”

“There it is,” The neurosurgeon pointed at the screen, “Small subdural bleed. It’s surgical. Get her prepped and I’ll meet you in the OR.”

Everyone began to leave when Dr. Jacobs stopped and looked at Conrad. “You are not coming anywhere near my OR,” He warned.

“I’m coming with her,” Conrad stated.

“No, you’re not,” Dr. Jacobs replied flatly.

“Dr. Jacobs,” Conrad protested, raising his voice.

“If you come into my OR, I will have you removed,” Dr. Jacobs pointed a finger in Conrad’s face, “You watch from the gallery. Do I make myself clear? 

Conrad’s jaw and fists were clenched tight, fighting every instinct to punch him. If Dr. Jacobs hadn’t been the best neurosurgeon Atlanta had to offer, he may have even considered it. Pravesh put a hand on his shoulder and eyed him cautiously .

“Come on, Conrad,” Pravesh said quietly, “Let him work. For Nic.”

Conrad agrees silently, still glaring at Dr. Jacobs as he leaves. Conrad went into the CT room and helped transfer Nic back onto the bed. They made quick work of getting her prepped and the anesthesiologist arrived to escort them to the OR.

As they approached the sterile line, Conrad leaned in close whispering to Nic. Whether or not she could hear him didn’t seem to matter; he just wanted to tell her.

“I love you so much Nic,” His voice trembled, “Don’t you give up on me now, okay? I need you.”

He hesitantly let the railing of the bed slip through his hands as the scrub nurse and anesthesiologist continued rolling her through the doors. He felt frozen in place, as he watched them shut, Nic disappearing from view and tears appearing on his cheeks.

“Conrad!” It was Bell approaching behind him, “I just heard.”

Conrad sniffled hard, pulling himself together before turning to him. 

“How is she?” Bell asked, his face was knit with concern and apology.

“Th-they just took her back,” Conrad reported, his voice still raw.

“Come on,” Dr. Bell said gently as he guided Conrad to the gallery.

Watching from behind the glass was a cruel form of torture for Conrad. Every moment that he spent watching them gown up, drape the area, make the first incision--he imagined the bleed growing larger and larger. He wanted to yell, scream at them to hurry up. Pravesh and Irving were also pressed to the window, watching intently.

The bone saw in Dr. Jacobs’ hand whirred to life before he pressed it steadily to Nic’s head.

Conrad had rotated in surgery. He’d seen this used hundreds of time. A bone saw was a common tool, the best way to get to the anatomy below the surface. It had always been fine.

But this was Nic.

Someone was drilling into Nic’s skull. Because she hit her head so hard, it was bleeding from the inside out. Because she had a seizure in his arms. Because she could barely breathe on her own. So when he heard the horrific sound of the drill cutting through her bone, he couldn’t take it. He had held it together so well for so long, but he couldn’t possibly stand another second of this. A wave of panic crushed him and suddenly every drop of blood seemed gone from his body 

“I’m gonna pass out,” he muttered.

Every head in the room snapped to look at his paling face, as he leaned with one hand on the glass and placed the other on his knee.

“Conrad, sit,” Bell rushed to hold his shoulders, directing him back a step to a chair, “Take a breath.” Conrad obeyed his orders, trying to fully inhale, but the sound of the drill is still choking him. He idly runs his fingers through his hair, his hands hovering as he fought the urge to cover his ears. Finally the noise stopped. Tears started to pool into his eyes as he gazed into the OR.

“Conrad,” Pravesh says softly, sitting in the chair next to him. He reaches over, placing his hand on Conrad’s wrist, both for comfort and to take his pulse.

Conrad glanced at Pravesh before his eyes returned to the OR.

“She-“ Conrad started, shaking his head as he became more upset. He looked back to Pravesh. “She has to be okay,” Conrad fell apart completely, almost begging through his tears, “Dev, she h-has to—has to be okay.”

Devon silently wrapped his arms around his sobbing friend. Everyone in the room shifted under the weight of his heavy emotion, each set of eyes left glistening.

“I know,” Devon replied quietly, “I know.”

And that was only the beginning of what felt like the longest surgery ever performed.

\-------

**A/N: here is a breakdown of all the medical info in this chapter!**

**This time she opened her eyes only for a moment and whimpered as she made a subtle attempt to push Conrad’s hand away: **We measure people’s level of consciousness out of 15 points with the Glasgow Coma Scale, which is abbreviated as GCS (you’ve probably heard plenty of times on medical shows, they’ll say “She has a GCS of 15”). It’s calculated by how a patient responds verbally (can they talk/does it make sense), what it takes to make them open their eyes (do you have to call their name/use painful stimuli, etc), and their motor response. What Nic does with her hands in response to painful stimuli falls under the motor category. Because she reacts by pushing him away, it shows that she is not only aware of the pain, but also where it is located, hence why it is called “localization.” Nic's GCS is 9 in this scene, which is definitely not great. Even a rock has a GCS of 3**. **Also, fun fact, I’ve never known an EMT who actually calculates this in their head while they are on the scene of an emergency. No time for calculations lol.

**“Conrad noted her irregular breathing”** // “**her pressure is way too high**”

These two findings together are significant in this scenario. First let’s start with the irregular breathing. There are lots of irregular patterns of breathing—you could breathe too fast, too slow, etc--but the one I had in mind while writing this is called Cheyne-Stokes breathing. It’s when a patient’s breathing picks up speed, then slows down until it stops, then repeats the cycle. It can be indicative of a few different things, but one of them is head injury. Now, about the high blood pressure. Cheyne-stokes breathing combined with hypertension (high blood pressure) make up 2 of the three criteria of Cushing’s Triad. The third is bradycardia (slow heart rate). Let’s assume Nic also had that. Cushing’s Triad is an indication that the Cushing Reflex has been triggered. What triggers the Cushing Reflex? Increasing pressure in the brain. What is one cause of increasing pressure in the brain? Bleeding in the brain! Boom. You just diagnosed Nic. You’re basically a doctor already.

**“No fever”**

This is important because it pretty much rules out meningitis.

**“A stroke?” **

So we know that Nic is showing signs of a brain bleed. A hemorrhagic stroke is definitely one reason why someone may have bleeding in the brain. A perfectly healthy woman in her early 30’s like Nic is at low risk for a stroke. Just like the meningitis theory, the key piece missing here is the head trauma.

**“There’s a hematoma on the back of her head” **

The hematoma strikes again! You guys remember what that is from chapter 1, right?

**“Roll her back down, _carefully_,” **

Whenever we suspect a head injury, we suspect a neck injury until it is officially ruled out. If you hit your head with enough force to injure you brain, it definitely could have been enough force to hurt the vertebrae that are only an inch away too. You have to move someone with a potential spinal injury very carefully because it can easily be worsened.

**“Struggling to position her jaw. ‘She’s not protecting her airway’”**

When someone is truly unconscious (not just sleeping), all of the muscles in the mouth/throat relax, causing them to sag into the airway and block it. It’s noted that Devon is trying to adjust her jaw because sometimes if you can position the jaw forward, it lifts all that tissue out of the way. It obviously doesn’t work, hence why Nic was intubated.

**“Okay, I’ve got bilateral breath sounds,”**

After intubating, you have to check that the tube is in the right place (the trachea) and hasn’t slid into just one of the lungs. “Bilateral” means both sides, so Nolan is saying that he can hear her breathing in both lungs, therefore the tube is correctly placed.

**“Small subdural bleed”**

Let’s break the word down. “Sub” means under and the “dura” is a membrane that surrounds the brain. A subdural bleed is bleeding that happens under the dura.

**“As they approached the sterile line**”

Most (maybe all, idk) hospitals have a literal line painted on the floor that signifies where the OR environment begins. That means you need to be sterile af to enter.

**“I’m gonna pass out,” **

Poor Conrad is literally worried sick. He has a vasovagal syncopal episode. I talked about syncope (fainting) in chapter 1. So why does this occur? After experiencing a distressing trigger (a bone saw drilling into a loved one, for example), the vagus nerve tries to combat the stress by sending signals to slow the heart and lower blood pressure. Unfortunately, the vagus nerve tried to chill him out a little too much, causing a lack of blood to the brain that makes him nearly pass out.


	3. Chapter 3

**Summary for the Chapter:**

> The third (and last, I believe, unless you have an idea) chapter is here! Enjoy the read!

It had been almost two days since Nic got out of surgery and Conrad hadn’t left her side. 

“SBT’s have been going great, she’s triggering the vent on her own,” Dr. Jacobs said as he peered at Nic’s chart, “I think we can start lightening sedation as well.”

“That’s great,” Conrad exhaled, nodding gratefully, “Thanks.”

Dr. Jacobs turned to his nurse and ordered a change in Nic’s medication dosages. Conrad tried not to think about the fact that Nic may wake up a different person. Or worse, not wake up at all 

He had poured over all of her test results. The surgery was successful, she had no complications, her post-op EEG was normal, and she was already an ideal candidate for a full recovery to begin with. There was no reason to believe that anything will go wrong, yet that’s the only thing he can think about. Nic needed to be okay. She had to be.

It was late when Devon came by after his shift.

“Hey man,” Devon spoke quietly, “How’s our favorite patient?”

“Good, good,” Conrad replied with a small sigh, “We’re backing off her sedation now.”

“I brought you a coffee and food,” Devon placed a cup and a sandwich down on the table before poking at him, “Remember that thing? Food? The stuff with the nutrition?”

“Yeah, yeah,” Conrad dismissed him with half a smile, “How was the ER?”

“It was a train wreck down there today,” Devon shrugged, plopping down in a chair.

Conrad smirked. “That bad, huh?”

“I’m pretty sure the only thing we didn’t get was an actual train wreck,” Devon said 

Suddenly an alarm began to ring and Nic’s head started to jerk back. Devon and Conrad were instantly next to her.

“Is she seizing?” Devon asked, unsure of what he was seeing.

“No, no, she’s bucking the vent,” Conrad explained before placing a hand on Nic’s shoulder and waist, “Nic? Nic can you hear me?” He gave her shoulder a light squeeze and her eyes opened.

Her panic heightened for a moment as her senses were flooded. She started grabbing at her face, desperately attempting to remove whatever was choking her. Conrad caught her frantic hands, stilling her.

“You’re alright, Nic, look at me,” Conrad said calmly, “Look at me.”

Nic followed the man’s directions and connected the familiar voice to the person above her--Conrad. She searched his face frantically, trying to figure out what was going on. Conrad read her expression.

“Nic, you had to get surgery,” Conrad told her plainly, “You have a tube in your throat helping you breathe--”

Nic started to shake her head in protest.

“You have to leave it in,” Conrad said apologetically.

Her eyes welled with tears as she continued to shake her head, quickly escalating. She withdrew away from him.

“Nic-“ Conrad warned.

She immediately reached for the tube tamer and tore the velcro off as Devon and Conrad jumped to stop her, trying to grab her hands 

“Wait, wait, wait, Nic stop!” Conrad gave in, grabbing a syringe as a show of good faith that he was going to remove it. “Hang on, I got you,” He murmured quietly as he deflated the balloon. “Big cough on three, okay?” He instructed as he gripped the tube, “One, two, three.”

Nic erupted into a coughing fit.

“There you go, easy, just breathe,” Conrad soothed.

Devon gently held an oxygen mask up to her face, which she gratefully gasped into. Once she slowed down, she finally rested her head back.

“C-“ she sputtered quietly.

“Shhh, don’t talk, just breathe,” Conrad said, watching her vitals on the screen.

“Stable,” Devon nodded at Conrad. “I’m going to go update Jacobs,” he said before leaving the room.

Conrad poured a cup of water and Nic took it with shaky hands. “Little sips, Nic,” Conrad reminded her. He took it back from her and placed it on the tray table. “Do you know where you are?” Conrad asked as he sat on the bed beside her.

“Chast-“ She replied, the rest of the word silent from her hoarseness.

“Good,” He smiled softly. 

“Conrad,” Nic breathed, reaching out towards him. She wanted something, someone, to hold onto, as if she would float away without it.

“That was the answer to my next question,” He smirked, scooting closer to hold her. He placed a small kiss to her forehead, just below the white bandage wrapped snug around her head. She sighed, sinking into him in relief. “Any pain?” He asked sweetly.

“Not really,” she shook her head, “What happened?”

“You hit your head and you needed surgery to fix—“ Conrad started.

“No, not like I’m a patient,” She interrupted, “Talk to me like I’m a nurse practitioner.”

A smile ghosted over Conrad’s lips. Nic is back.

“You had a subdural hematoma,” He sighed, wishing he didn’t have to relay upsetting details to her, “You told me that you had a headache and then you had a seizure. We had to intubate you in the ER because you couldn’t maintain your airway. You had a pretty big hematoma on the back of your head, so we knew you must have had some trauma and the CT showed a bleed. We brought you right to surgery.”

“I hit my head having a seizure?” She asked, a bit confused. It all sounded so scary and she had never had a seizure before.

“No, no,” Conrad reassured her, “I think you had an aura because you told me something was about to happen. It gave me the chance to make sure you didn’t fall or anything. Your symptoms started before that—headache, vomiting—so it must have happened earlier in the day. Do you remember anything that happened? 

“No,” Nic replied, her forehead creasing with contemplation.

“Maybe it’ll come back to you,” Conrad shrugged 

“Who operated?” She asked with sudden concern.

“Dr. Jacobs,” He replied. Nic sighed in relief.

“Anyone but Cain,” She rolled her eyes.

“You really think I’d let Cain come anywhere near you with a ten blade?” He said with a small smile. 

“How long have I been sedated?” She glanced around, trying to figure out the time of day.

“Two days,” He replied as he rested a hand on her cheek.

“I’m so tired,” she mumbled, melting into his touch. 

“I bet,” Conrad said, resting his chin on the railing, “We only lowered the propofol a few hours ago. Just rest, Nic. I’m right here.”

Nic’s heart swelled as she heard him say it: _I’m right here_.

Nic was terrified by what had happened and terrified of every possible complication she could have in recovery. She never said it, but he reassured her all the same because he already knew--because he was scared too. All at once, she trusted that she could fall apart in front of him; he was safety. If anyone could understand, it was Conrad.

Her face started to tense as tears rose into her eyes 

“It’s okay Nic,” Conrad whispered, wiping away an escaped tear.

She recognized that his words sounded more like permission than reassurance and she gave in, her tears falling in force. “Conrad,” she choked, her hand climbing up his strong arm, feeling like it wasn’t enough to hold onto.

Conrad collapsed the rail of the bed and slid in next to her, carefully holding her close. She only started to cry harder and he was heartbroken to see her so upset. “I’m right here, Nic,” Conrad said gently, “You’re safe.”

Both of them understood all too well the gravity of her injury. Every medical provider has lost a patient to a brain bleed at one point or another. They just held onto each other, thanking gods they didn’t believe in that Nic was an exception.

They stayed just like that for a little while, until Nic’s tears stopped flowing. Conrad thought she may have cried herself to sleep, but then he heard her small voice.

“Conrad,” She whispered, “I love you.”

“I love you too Nic.”

**\----EPILOGUE-----**

It had been a week since Nic was discharged from the hospital. Conrad took time off to stay at home with her, since she was still recovering. She was progressing really well in physical therapy and was almost back to her old self. She was grabbing a glass of water when she accidently brushed something off of the counter and onto the floor. She saw it was her ID badge for work and squatted down very slowly and carefully to pick it up. As she reached out for it, she paused.

_The tray hitting the linoleum floor._

_The impact of a metal bar._

Conrad entered the room and froze as saw Nic kneeling on the floor of the kitchen, her eyes distant. A seizure? A syncopal episode?

“Nic!” He called, immediately next to her 

“I remember,” She muttered.

“What?” Conrad asked in confusion.

“I remember,” Nic looked at him, deep in thought, “It was Pravesh’s psychotic patient in the ER that day. I dropped my ID under a bed and I was trying to get it… But someone dropped a tray and I jumped and hit my head so hard on the metal bar under there…” Her face lit up. “Whoa. I remember.”

Conrad was honestly just relieved that nothing terrible was happening.

“That’s incredible, Nic,” He smiled, holding onto her shoulders as he helped her up. Her eyes were so bright and vivid. So alive. God, she was _alive_. He couldn’t control the warm smile that spread across his face. Nic paused 

“Conrad?” she squinted at him with a giggle, trying to read his brown eyes.

“I love you Nic,” He said simply.

Nic stepped forward and kissed him softly.

“I love you too Conrad.”

\---------

**A/N: Here is the medical scoop for this chapter!**

**“SBT’s have been going great, she’s triggering the vent on her own,”**

So here’s the full disclosure: I’m an EMT so I don’t really deal with patients who are on ventilators. The knowledge I have on it is very limited, so take my info with a grain of salt. When someone is on a ventilator and the doctors want to wean them off of it, they have to figure out if the patient can breathe on their own. To see if the patient is ready, they do SBT’s, which stands for short breathing test. They reduce or stop the ventilator for a few moments and then see if the patient breathes adequately without the assistance of the ventilator.

**Nic may wake up a different person. Or worse, not wake up at all.**

It is possible for a brain surgery/injury to affect the patient’s ability to walk, speak, think, etc.

**Her post-op EEG was normal**

An electroencephalogram (eh-LEC-troh en-SEF-ah-low-gram) tests electrical activity in the brain. Electrodes are glued onto the scalp of the patient and the activity is measured in waves (sort of like a heart monitor, but for the brain). They are most often used in the general population for seizure detection. In the case of an unconscious person like Nic, it would be used to make sure that the patient is not brain dead or having subclinical seizures (a subclinical seizure is when a patient has the electrical activity of a seizure, but does not outwardly appear to be having a seizure).

**She was already an ideal candidate for a full recovery to begin with.**

Let’s talk about why. We already discussed that Nic is a healthy woman in her 20’s/30’s. I forget the exact statistic, but the mortality rate of a brain bleed for people over the age of 40 is double the mortality rate of younger people. So she age and health on her side. She also had a relatively high GCS before surgery. People with higher GCS scores prior to surgery have a much better chance of survival/full recovery. Remember, even a rock has a GCS of 3.

**“No, no, she’s bucking the vent”**

When someone is “bucking” the ventilator, it means that they are breathing out of rhythm with the machine (ventilator dysynchrony). It can happen for a lot of different reasons, like incorrectly adjusted settings on the ventilator, but also happens when sedation becomes too light. When Nic is waking up and realizes she has a tube in her throat, she freaks out (rightfully so) and bucks the vent.

**He gave her shoulder a light pinch and her eyes opened**

So this is just like the sternal rub to help someone wake up, but it’s a hard squeeze to the shoulder muscle instead (the meaty one near the neck). It’s called a “trap squeeze” because you’re squeezing the trapezius muscle. Go on, try it, it really does hurt! I prefer using a trap squeeze on my patients because the sternal rub can leave a bruise, but the trap squeeze doesn’t do any damage.

**She immediately reached for the tube tamer and tore the velcro off**

A “tube tamer” is like a plastic ring that holds all the tubes and secures them onto the patient’s face with a strap. That way, the tubes don’t get tugged on as easily and they don’t get all tangled up.

**Grabbing a syringe as a show of good faith that he was going to remove it**

This is another area that is beyond what I do as an EMT, so I’ve never done this. Around the tube that goes in the airway, there is a little inflatable doughnut towards the bottom end. It gets inflated to create a tight seal so air isn’t escaping in between ventilations. Before taking the tube out, you deflate the doughnut by pulling air out of it with a syringe. Once it’s deflated, it’s easier to remove the tube. So when Conrad shows her the syringe, she knows that means he’s going to help her take it out.

**I think you had an aura because you told me something was about to happen**

An “aura” is like a warning sensation a person gets before they have a seizure (this is NOT the same thing as a “spiritual aura” where people’s energy is associated with a color). Auras differ from person to person, and some people don’t have them at all. It could be a certain taste, a feeling of doom, or just about anything you could feel, physically or emotionally. I have epilepsy and during my aura, my right arm goes numb and I feel nauseous. You might remember Nic said “something’s wrong” right before her seizure started, so Conrad thinks she probably was experiencing an aura at the time.

**You really think I’d let Cain come anywhere near you with a ten blade?**

A ten blade is a type of scalpel used in the OR.

**We only lowered the propofol a few hours ago**

Propofol is a drug used as anesthesia (to make a person unconscious).


End file.
